What is ivermectin?
Ivermectin is an anti-parasite medication used to treat parasitic diseases. It is FDA approved for use in humans to treat a variety of parasitic infections including parasitic worms, hookworm and whipworm. Ivermectin may also be used as an effective treatment for a wide range of other conditions and as a treatment of onchocerciasis, intestinal strongyloidiasis and onchocerciasis or river blindness.
The antiviral activity of Ivermectin has been shown against a wide range of RNA and DNA viruses, for example, dengue, Zika, yellow fever, and others.
Ivermectin and Covid-19 Treatment
Ivermectin is currently being investigated in a clinical trial as a potential COVID-19 treatment for the coronavirus SARS-CoV-2 Virus, which is the virus that causes COVID-19. The FDA has not approved ivermectin for use in treating or preventing COVID-19 infection in humans. The World Health Organization (WHO) recommend not to use ivermectin in patients with COVID-19 to reduce viral replication, except in clinical trials.
Experimental studies for ivermectin as an adjunct treatment for antiviral effects of hospitalized adult COVID-19 patients: a randomized multi-center clinical trial. There is currently insufficient evidence from the COVID-19 Treatment Guidelines Panel to recommend either for or against the use of ivermectin in Covid-19 patients for the treatment of severe or mild COVID-19 symptoms.
Click for further information on using ivermectin to treat COVID-19 and other prevention and investigational treatments and discuss with your health care provider.
The CDC are reporting adverse effects associated with ivermectin misuse and overdose are increasing. In some cases people have taken veterinary products intended for use in large animals such as horses, sheep, and cattle. These products are highly concentrated and result in overdoses when used by humans.
DO NOT TAKE IVERMECTIN PRODUCTS INTENDED FOR ANIMAL USE.
Warnings
You will need to have a stool exam after taking ivermectin to make sure the infection is gone. Some patients may need to take another dose of ivermectin to treat the infection.
Ivermectin may make you feel dizzy. To lower the chance of feeling dizzy or passing out, rise slowly if you have been sitting or lying down. Be careful going up and down stairs.
Before taking this medicine
You should not use ivermectin if you are allergic to it.
To make sure ivermectin is safe for you, tell your doctor if you have:
- liver or kidney disease; or
- cancer, HIVor AIDS, or other conditions that can weaken your immune system.
It is not known whether ivermectin will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.
Ivermectin can pass into breast milk and may harm a nursing baby. Tell your doctor if you are breast-feeding a baby.
Ivermectin should not be given to a child who weighs less than 33 pounds (15 kg).
Ivermectin pregnancy and breastfeeding warnings (more detail)
How should I take ivermectin?
Never take ivermectin in larger amounts, or for longer than recommended by your doctor. Follow all directions on your prescription label.
Take ivermectin on an empty stomach, at least 1 hour before or 2 hours after a meal.
Ivermectin is usually given as a single dose. Take this medicine with a full glass of water.
To effectively treat your infection, you may need to take ivermectin again several months to a year after your first dose.
If you have a weak immune system (caused by disease or by using certain medicine), you may need to take more than one dose of ivermectin. Some people who have a weak immune system need to take this medicine on a regular basis. Follow your doctor’s instructions.
To make sure this medicine is working, you may need to provide frequent stool samples.
Store this medicine at room temperature away from moisture and heat.
Dosing information
Usual Adult Dose of Ivermectin for Onchocerciasis:
0.15 mg/kg orally once every 12 months
Patients with heavy ocular infection may require retreatment every 6 months. Retreatment may be considered at intervals as short as 3 months.
Dosage guidelines based on body weight:
15 to 25 kg: 3 mg orally one time
26 to 44 kg: 6 mg orally one time
45 to 64 kg: 9 mg orally one time
65 to 84 kg: 12 mg orally one time
85 kg or more: 0.15 mg/kg orally one time
Usual Adult Dose for Strongyloidiasis:
0.2 mg/kg orally once
In immunocompromised (including HIV) patients, the treatment of strongyloidiasis may be refractory requiring repeated treatment (i.e., every 2 weeks) and suppressive therapy (i.e., once a month), although well-controlled studies are not available. Cure may not be achievable in these patients.
Dosage guidelines based on body weight:
15 to 24 kg: 3 mg orally one time
25 to 35 kg: 6 mg orally one time
36 to 50 kg: 9 mg orally one time
51 to 65 kg: 12 mg orally one time
66 to 79 kg: 15 mg orally one time
80 kg or more: 0.2 mg/kg orally one time
Usual Adult Dose for Ascariasis:
0.2 mg/kg orally once
Usual Adult Dose for Cutaneous Larva Migrans:
0.2 mg/kg orally once
Usual Adult Dose for Filariasis:
0.2 mg/kg orally once
Study (n=26,000)
Mass treatment in Papua, New Guinea:
Bancroftian filariasis: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years
Usual Adult Dose for Scabies:
0.2 mg/kg orally once, and repeated in 2 weeks
Ivermectin therapy may be combined with a topical scabicide.
Usual Pediatric Dose for Filariasis:
Study (n=26,000)
Mass treatment in Papua, New Guinea:
Bancroftian filariasis:
5 years or older: 0.4 mg/kg orally once yearly (with a single annual dose of diethylcarbamazine 6 mg/kg), for 4 to 6 years
Detailed Ivermectin dosage information
What happens if I miss a dose?
Since ivermectin is usually given in a single dose, you may not be on a dosing schedule. If you are on a schedule, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to make up the missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What to avoid
Drinking alcohol can increase certain side effects of ivermectin.
Ivermectin side effects
Get emergency medical help if you have signs of an allergic reaction to ivermectin: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Call your doctor at once if you have:
- eye painor redness, puffy eyes, problems with your vision;
- severe skin rash, itching, or rash with pus;
- confusion, change in your mental status, balance problems, trouble walking;
- fever, swollen glands, stomach pain, joint pain, swelling in your hands or feet;
- fast heart rate, trouble breathing;
- loss of bladder or bowel control;
- neck or back pain, seizure (convulsions); or
- a light-headed feeling, like you might pass out.
Common ivermectin side effects may include:
- headache, muscle aches;
- dizziness;
- nausea, diarrhea; or
- mild skin rash.
This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
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